On the Urology Workforce, Targeted Screening,
And the US Preventive Services Task Force


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It is abundantly clear that the US Preventive Services Task Force Draft Guidelines on Prostate Cancer Screening will not be welcome news to many urologists. I have attended numerous annual meetings of the American Urological Association, the physician organization for urologists. The majority of papers  concern that walnut-shaped gland, the prostate, usually taking up prostate cancer or an enlarged prostate, AKA BPH (benign prostatic hyperplasia). Some urology practices focus  exclusively on the prostate. Urologists will need to readjust.

As one doctor who has nothing to do with the US Preventive Services Task Force told me: “There is plenty of honest urology for them to practice….stones, incontinence, kidney cancer etc. But even in the world of prostate cancer a good 20% to 30% of patients have bad enough disease that they deserve attention and, perhaps, more of it than they have been given in the past due to the crazed gold rush towards the low-risk men.” I agree totally with this statement. If Americans could vote with their feet, I think too that they would want urologists to treat the truly important areas in urology, rather than a disease that the odds are will not cause trouble for most men.

Jeez, it would be welcome news if the public understood this and if it was talked about more openly. As a reporter, I have witnessed the fleeing of docs from real medicine to cosmetic surgery and the rich. How refreshing it would be if urology began to turn out more doctors that patients need.

On another note, the Draft Recommendations that will be released officially tomorrow are expected to address concerns of high-risk individuals. The word is out that there will be a call for research into whether or not there should be targeted screening. In other words, should high-risk men (e.g. because of family history) be screened, and at what intervals? That should come as some comfort to people who worry that the high risk will be lumped into one healthy asymptomatic category.

The comment period begins after the official release tomorrow. If you have thoughts about the draft recommendations, positive or negative, get them on the public record. There’s plenty that patients and the public  will want to mull over. Ask questions and don’t leave it to someone else.  I’ll be following this issue, providing follow-up links on where to send your comments, and more.


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And the US Preventive Services Task Force


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